PhD/PsyD Accommodations and neuropsych assessments?

[Mr.Smile12]

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I wanted this community's perspective about this question that appeared among prehealth advisors, namely with requesting testing accommodations for the MCAT or similar exams.

Apparently, the powers that be that issue accommodations to a requesting candidate have asked them to submit a neuropsychiatric assessment as deemed necessary from AAMC to make a decision about granting testing accommodations. While students may be able to access campus psychological services, higher ed resources are highly constrained. Students seem to be referred to private practices that would charge $5K-$10K to conduct an acceptable assessment.

I know the danger of lacking more specific details here, but I want to understand the rationale. Or if there are specific details I need to ask more about.

 

[AcronymAllergy]

I wanted this community's perspective about this question that appeared among prehealth advisors, namely with requesting testing accommodations for the MCAT or similar exams.

Apparently, the powers that be that issue accommodations to a requesting candidate have asked them to submit a neuropsychiatric assessment as deemed necessary from AAMC to make a decision about granting testing accommodations. While students may be able to access campus psychological services, higher ed resources are highly constrained. Students seem to be referred to private practices that would charge $5K-$10K to conduct an acceptable assessment.

I know the danger of lacking more specific details here, but I want to understand the rationale. Or if there are specific details I need to ask more about.

I suspect what may have been requested is a neuropsychological assessment as opposed to a neuropsychiatric assessment? Or maybe a psychoeducational assessment?

Requiring a psychoeducational assessment is relatively routine for "high stakes" testing accommodations (e.g., MCAT, GRE, LSAT, SAT) and typically includes a semi-prescribed assessment battery to establish the presence of the disorder(s) in question, to rule-out other potential factors, etc. This has been the case for many years (i.e., pre-dates my time in grad school, which is a bit longer ago than I sometimes care to admit nowadays). Although as an admissions advisor, you may be more well-acquainted with this than I am at this point.

If they're specifically requesting a neuropsychiatric or neuropsychological evaluation, it sounds like it may relate to something other than the more standard accommodations-related conditions, such as a learning disorder or ADHD.

It's hard to provide a rationale without knowing a bit more about the situation, unless it's a general question about the rationale behind requiring a psychoeducational assessment for accommodations on testing? I could potentially see requesting/requiring a neuropsychological evaluation for a congenital or acquired neurological condition, or something else broadly thought to be affecting cognition.

 

[MCParent]

I wanted this community's perspective about this question that appeared among prehealth advisors, namely with requesting testing accommodations for the MCAT or similar exams.

Apparently, the powers that be that issue accommodations to a requesting candidate have asked them to submit a neuropsychiatric assessment as deemed necessary from AAMC to make a decision about granting testing accommodations. While students may be able to access campus psychological services, higher ed resources are highly constrained. Students seem to be referred to private practices that would charge $5K-$10K to conduct an acceptable assessment.

I know the danger of lacking more specific details here, but I want to understand the rationale. Or if there are specific details I need to ask more about.

I can’t imagine the fluffing up of reported time to do the assessment and write the report that would drive the cost to $5k, let alone 10.

It’s not cheap but I never charged that. Granted I think I can administer a WAIS/WIAT by memory now.

 

[Sanman]

I suspect what may have been requested is a neuropsychological assessment as opposed to a neuropsychiatric assessment? Or maybe a psychoeducational assessment?

Requiring a psychoeducational assessment is relatively routine for "high stakes" testing accommodations (e.g., MCAT, GRE, LSAT, SAT) and typically includes a semi-prescribed assessment battery to establish the presence of the disorder(s) in question, to rule-out other potential factors, etc. This has been the case for many years (i.e., pre-dates my time in grad school, which is a bit longer ago than I sometimes care to admit nowadays). Although as an admissions advisor, you may be more well-acquainted with this than I am at this point.

If they're specifically requesting a neuropsychiatric or neuropsychological evaluation, it sounds like it may relate to something other than the more standard accommodations-related conditions, such as a learning disorder or ADHD.

It's hard to provide a rationale without knowing a bit more about the situation, unless it's a general question about the rationale behind requiring a psychoeducational assessment for accommodations on testing? I could potentially see requesting/requiring a neuropsychological evaluation for a congenital or acquired neurological condition, or something else broadly thought to be affecting cognition.

Agreed with this. I will add that I assumed they want some proof when it comes to high stakes accommodations. Campus psych services are not usually equipped to handle these questions in my experience.

 

[Sanman]

I can’t imagine the fluffing up of reported time to do the assessment and write the report that would drive the cost to $5k, let alone 10.

It’s not cheap but I never charged that. Granted I think I can administer a WAIS/WIAT by memory now.

You have done this more recently than I. Normally, $2500-5k would be what I would assume. That said, depending on the clientele, I can imagine there being a mark-up. I really hate dealing with overbearing parents and $10k would ease that burden considerably.

 

[cara susanna]

Wait, is a neuropsychiatric assessment actually a thing? I always assumed it was people using an incorrect term for neuropsychological assessment.

 

[MCParent]

You have done this more recently than I. Normally, $2500-5k would be what I would assume. That said, depending on the clientele, I can imagine there being a mark-up. I really hate dealing with overbearing parents and $10k would ease that burden considerably.

2500ish was my normal fee. My battery met the MCAT/LSAT/GRE reqs and I felt happy about my time to money ratio. But like I said I could do the tests by memory, short of digit span, having taught them for years and done or supervised hundreds.

I dunno, overbearing parents + $10k + a negative diagnosis seems like a recipe for disaster 🤣 tbh I’d assume folks charging that much are just selling positive tests.

 

[AcronymAllergy]

Wait, is a neuropsychiatric assessment actually a thing? I always assumed it was people using an incorrect term for neuropsychological assessment.

Yes, it's a thing, although I'd say it's essentially an evaluation performed by a neuropsychiatrist. I haven't seen them very often outside of academic medical settings. Similar to how there are exams by behavioral neurologists that differ in ways from a more standard neurological exam. In my experience, though, as you've said, it's usually been a someone who actually wanted a neuropsychological evaluation. Typically not a big deal.

As for pricing, in my experience, $5k is not unheard of, but $10k is definitely high. As has been suggested, if someone is paying that much for an evaluation, like it or not, they're probably going to have expectations about the results. I'm happy to deal with those issues in a medicolegal setting interacting with attorneys where it's expected to be adversarial. Wouldn't want to have to deal with that in a quasi-clinical setting (whether or not it's actually clinical).

 

[PsyDr]

...., but I want to understand the rationale. Or if there are specific details I need to ask more about.

The Rationale
The chances that a college student failed because they have a learning disorder that went undiscovered while they went through elementary, high school, and the ACTs/SATs, and the disorder was not sufficiently impairing to stop them from getting into college, only to suddenly present and impair at 19 is low. The administrators know that the typical reasons for class failure is students doing 18-22 year old BS (e.g., going out every night, drinking beer, skipping class, not reading the material, falling in love, staying up late for no reason, etc). Usually people try to avoid the consequences of their actions. Claiming you failed because you have a learning disorder...it's a solid move. What's an administrator to do? Easiest thing is for the administrators to require proof. And because the MCAT, LSAT, and GRE already have testing requirements for extra time, the administrators can adopt those requirements, stating "We are preparing our students for further education, and we use the standards of medical school and law school. So that is what we use".

That's pretty much the rationale.



ps. The average endowment of the 379 ranked colleges in US News is $1.6 BILLION. It's disenguous to say that the price of testing is the the issue. The issue is "who is paying for this". The schools could directly hire a fleet of neuropsychologist, or contract with them if they wanted to pay for it.