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Bernard JL, Witmer SE. Examining How Students With ADHD Use an Extended Time Accommodation on a Low-Stakes Math Assessment. J Atten Disord 2025:10870547251332046. [PMID: 40219665 DOI: 10.1177/10870547251332046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2025]
Abstract
OBJECTIVE Students with ADHD are often provided with an extended testing time accommodation due to various skill deficits. However, little empirical work has examined the ways in which students use their extra time, if at all, and how use relates to overall performance. Further understanding of how students use this accommodation in practice can help to inform accommodation decision-making procedures so that students with disabilities recieve the appropiate support to be able to demonstrate their underlying knowledge and skills on tests. METHOD The current study utilized the National Assessment of Educational Progress (NAEP) 2017 eighth-grade process data to examine the use and nonuse of extended time accommodations among students with ADHD as well as among comparison groups. RESULTS Less than half of students with ADHD who were eligible for an extended time accommodation used it. Access to the accommodation, rather than actual use, corresponded to higher rates of test completion. Those students who spent more time on the final five items of the test performed better overall when compared to their peers. CONCLUSION Findings raise questions about the underlying needs of students with ADHD during testing and whether mere access to extended time sufficiently addresses those needs. Additional critical analysis of the provision and use of extended time for students with attention problems appears warranted. Implications for future research and practice are offered.
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Trane FE, Paulich KN, Dokuru DR, Willcutt EG. Contributions of Working Memory, Inhibition, and Processing Speed to Writing Composition in Attention-Deficit/hyperactivity Disorder. Dev Neuropsychol 2025:1-23. [PMID: 40029094 DOI: 10.1080/87565641.2025.2472060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 02/14/2025] [Accepted: 02/20/2025] [Indexed: 03/05/2025]
Abstract
Children with Attention-Deficit/Hyperactivity Disorder (ADHD) often struggle with writing composition, possibly due to deficits in executive functions and processing speed. This study examined 518 children with ADHD and 851 controls to assess these effects. Multiple mediation tested whether executive functions (i.e., working memory, inhibition) and processing speed partially mediated the association between inattention and writing composition, controlling for transcription. Results showed inattention negatively predicted writing composition. Executive function accounted for nearly 10%, and processing speed nearly 17%, of the variance in this association. Findings highlight the contributions of executive functions and processing speed to writing difficulties in ADHD.
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Affiliation(s)
- Francesca E Trane
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA
| | - Katie N Paulich
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA
| | - Deepika R Dokuru
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA
| | - Erik G Willcutt
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA
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Attention-Deficit/Hyperactivity Disorder and Academic Functioning: Reading, Writing, and Math Abilities in a Community Sample of Youth with and without ADHD. Res Child Adolesc Psychopathol 2023; 51:583-596. [PMID: 36480079 DOI: 10.1007/s10802-022-01004-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 12/13/2022]
Abstract
Previous studies have shown that Attention-Deficit/Hyperactivity disorder (ADHD) is marked by impairments in academic functioning in reading, writing, and mathematics. Yet, virtually no studies have examined academic functioning in terms of both basic skills (e.g., word recognition, handwriting/spelling, arithmetic calculations) and more complex advanced skills (e.g., reading comprehension, writing composition, and mathematical problem-solving) within the same sample. In the present study, 518 children with ADHD were compared to a control group of 851 children without ADHD (ages 8-18) and assessed on a comprehensive battery of reading, writing, and math assessments. It was hypothesized that ADHD diagnostic status would uniquely predict performance on advanced skill measures even after controlling for performance on basic skills in that academic domain. ADHD status was associated with worse performance across all academic tests. Results also indicated that ADHD independently predicted performance for measures of writing composition and one measure of reading comprehension, even after controlling for performance on basic skills in those domains. However, ADHD did not independently predict mathematical problem-solving performance. These findings add to the literature on ADHD and academic functioning and indicate that inattention may weaken skills necessary for effective reading comprehension and writing composition.
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Harrison AG, Armstrong I. Accommodation Decision-Making for Postsecondary Students with ADHD: Treating the Able as Disabled. PSYCHOLOGICAL INJURY & LAW 2022; 15:367-384. [PMID: 36068830 PMCID: PMC9437389 DOI: 10.1007/s12207-022-09461-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 08/23/2022] [Indexed: 11/26/2022]
Abstract
Students with attention-deficit/hyperactivity disorder (ADHD) may be entitled to academic accommodations in postsecondary education. Disability Services Offices (DSOs) in Canada say that objective evidence of functional impairment is required prior to providing academic accommodations. This study set out to determine if postsecondary disability service providers use objective, third-party data when making accommodation decisions. Providers were asked if they would grant extra time accommodations to a fictitious prospective student. The student self-reported attention and academic problems that emerged during COVID restrictions, and that extra time helped her earn better grades and reduced her anxiety. While her neuropsychological report suggested superficial similarity to ADHD and contained accommodation recommendations, it lacked any objective evidence supporting either an ADHD diagnosis or functional impairments that would support extra time accommodation. Despite the lack of current or historical functional impairment, 100% of all DSO decision makers confirmed that they would grant extra time accommodations to this student. Results suggest that DSOs’ accommodation decisions are not based on evidence of functional impairment but rely mainly on student self-report and the recommendations of a professional. As such, the current system of determining reasonable accommodations is flawed and inequitable, offering non-impaired individuals access to supports and services that may privilege them over their similarly abled peers. Postsecondary institutions must either develop more defensible methods of disability determination or provide all students with access to accommodations to create a more equitable learning environment.
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Parks KMA, Moreau CN, Hannah KE, Brainin L, Joanisse MF. The Task Matters: A Scoping Review on Reading Comprehension Abilities in ADHD. J Atten Disord 2022; 26:1304-1324. [PMID: 34961391 DOI: 10.1177/10870547211068047] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE A broad range of tasks have been used to classify individuals with ADHD with reading comprehension difficulties. However, the inconsistency in the literature warrants a scoping review of current knowledge about the relationship between ADHD diagnosis and reading comprehension ability. METHOD A comprehensive search strategy was performed to identify relevant articles on the topic. Thirty-four articles met inclusion criteria for the current review. RESULTS The evidence as a whole suggests reading comprehension is impaired in ADHD. The most prominent effect was found in studies where participants retell or pick out central ideas in stories. On these tasks, participants with ADHD performed consistently worse than typically developing controls. However, some studies found that performance in ADHD improved when reading comprehension task demands were low. CONCLUSION Results suggest that performance in ADHD depends on the way reading comprehension is measured and further guide future work clarifying why there are such discrepant findings across studies.
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Johnson EEH, Suhr J. Self-reported functional impairment in college students: relationship to noncredible reporting, ADHD, psychological disorders, and other psychological factors. J Clin Exp Neuropsychol 2021; 43:399-411. [PMID: 34078250 DOI: 10.1080/13803395.2021.1935490] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Both symptoms and functional impairment should be assessed in college students seeking evaluations for Attention Deficit Hyperactivity Disorder (ADHD). However, impairment is not specific to ADHD. Although it is well documented that self-reported symptoms can be reported noncredibly, there is less research examining credibility of self-reported impairment, and few clinicians rule out alternative causes for impairment. METHOD Participants (N = 428) completed self-report measures of functional impairment, sleep, perceived stress, and in an ADHD symptom measure with embedded validity indicators. RESULTS Noncredible reporters endorsed greater functional impairment than credible reporters in several domains, but impairment was reported at a high rate even in credible responders (N = 323) in several domains. Participants who reported prior ADHD and participants who reported prior psychiatric diagnoses reported greater impairment and higher rates of clinically significant impairment than those who reported no prior diagnoses. Few differences in reported impairment emerged between those who reported ADHD and psychiatric diagnoses. Sleep and stress accounted for significant variance in impairment, and the ADHD group reported greater impairment than the psychiatric diagnosis and no diagnosis groups after controlling for these variables. CONCLUSIONS Results reinforce the importance of considering the validity of, and alternative sources for, self-reported impairment in college students with ADHD concerns.
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Affiliation(s)
| | - Julie Suhr
- Department of Psychology, Ohio University, Athens, OH, USA
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Lovett BJ, Nelson JM. Systematic Review: Educational Accommodations for Children and Adolescents With Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry 2021; 60:448-457. [PMID: 32745597 DOI: 10.1016/j.jaac.2020.07.891] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/25/2020] [Accepted: 07/24/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) often receive instruction and take tests using educational accommodations. This review aims to summarize and integrate the research literature on accommodations for this specific population. METHOD Electronic databases in medicine (MEDLINE), psychology (PsycINFO), and education (ERIC) were systematically searched (last update January 13, 2020), with inclusion criteria selecting any document with a focus on accommodations in educational settings or on academic tasks for children or adolescents with ADHD. The search yielded 497 unique documents. Additional searches yielded 13 more documents. Of the 510 total potentially useful documents, 68 met criteria for topical relevance and age range, to be discussed in the narrative review. The wide range of document types led to a qualitative synthesis. RESULTS Accommodations are by far the most common response to ADHD in educational settings, with testing accommodations such as extended time being particularly prevalent. However, most accommodations fail to show evidence of benefits that are specific to students with ADHD, and many of the more common accommodations have few or no experimental studies supporting them. An exception is read-aloud accommodations, which have two randomized experiments finding specific benefits for younger students with ADHD. Students and those who work with them often express ambivalence and dissatisfaction over the accommodations process. CONCLUSION More empirical research is needed to examine the effects of these extremely common supports. In the absence of supportive evidence, health professionals should be hesitant to recommend accommodations immediately after a diagnosis. Even when such evidence exists, educational accommodations should only be provided along with evidence-based interventions, or after interventions have failed, as suggested by the "life course" model of managing ADHD.
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Affiliation(s)
- Benjamin J Lovett
- School Psychology Program, Teachers College, Columbia University, New York.
| | - Jason M Nelson
- Regents Center for Learning Disorders, University of Georgia, Athens
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Hustus CL, Evans SW, Owens JS, Benson K, Hetrick AA, Kipperman K, DuPaul GJ. An Evaluation of 504 and Individualized Education Programs for High School Students With Attention Deficit Hyperactivity Disorder. SCHOOL PSYCHOLOGY REVIEW 2020. [DOI: 10.1080/2372966x.2020.1777830] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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9
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Harrison JR, Evans SW, Baran A, Khondker F, Press K, Noel D, Wasserman S, Belmonte C, Mohlmann M. Comparison of accommodations and interventions for youth with ADHD: A randomized controlled trial. J Sch Psychol 2020; 80:15-36. [DOI: 10.1016/j.jsp.2020.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/20/2020] [Accepted: 05/06/2020] [Indexed: 01/23/2023]
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10
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Zadelaar JN, Dekkers TJ, Huizenga HM. The association between risky decision making and attention‐deficit/hyperactivity disorder symptoms: A preregistered assessment of need for cognition as underlying mechanism. JOURNAL OF BEHAVIORAL DECISION MAKING 2020. [DOI: 10.1002/bdm.2177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
| | - Tycho J. Dekkers
- Department of Psychology University of Amsterdam Amsterdam The Netherlands
- Department of Forensic Psychiatry and Complex Behavioral Disorders De Bascule, Academic Center for Child‐ and Adolescent Psychiatry Amsterdam The Netherlands
- Department of Child and Adolescent Psychiatry Amsterdam UMC, Free University Medical Center (VUmc) Amsterdam The Netherlands
- Department of Psychology University of Central Florida Orlando Florida
| | - Hilde M. Huizenga
- Department of Psychology University of Amsterdam Amsterdam The Netherlands
- Amsterdam Brain and Cognition Center University of Amsterdam Amsterdam The Netherlands
- Research Priority Area Yield University of Amsterdam Amsterdam The Netherlands
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Jansen D, Petry K, Evans SW, Noens I, Baeyens D. The Implementation of Extended Examination Duration for Students With ADHD in Higher Education. J Atten Disord 2019; 23:1746-1758. [PMID: 30058447 DOI: 10.1177/1087054718787879] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Recently, research indicated that extended examination duration was perceived as effective by students with ADHD. However, the objective effectiveness of this accommodation has not been researched extensively. This study addresses this gap in literature. METHOD A total of 30 students with ADHD and 30 matched typically developing controls (TDC) participated in a simulation of a real-life examination. They filled in three parallel versions of a paper-and-pencil test in three time conditions: 1 hr (+0%), 1 hr 20 min (+33%), and 1 hr 30 min (+50%). RESULTS When granted extended examination duration, students with ADHD and TDC use extra time but their performance does not increase. In addition, test-taking strategies were altered to a limited extent, and strategies that are perceived as effective (e.g., marking key words) were rarely used by the students. CONCLUSION It is concluded that extended examination duration is not objectively effective in an experimental design. Limitations and guidelines for future research are formulated.
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Comparing Two Methods of Delivering ThinkRx Cognitive Training to Children Ages 8–14: a Randomized Controlled Trial of Equivalency. JOURNAL OF COGNITIVE ENHANCEMENT 2019. [DOI: 10.1007/s41465-018-0094-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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13
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Abstract
Objective: To investigate whether administration of a common ADHD screener followed by generic feedback would affect college students' subsequent symptom reports and cognitive performance. Method: Participants were 157 college students randomly assigned to an experimental group-which completed the World Health Organization Adult ADHD Self-Report Scale screener and received standard generic feedback-or a control group. All participants then completed a battery of cognitive tasks and a long-form symptom rating scale. Results: The experimental and control groups did not differ significantly in terms of their subsequent symptom reports or their performance on any cognitive tasks. These null results remained after considering possibilities such as unequal group variances and interactions between screening effects and gender. Conclusion: When administered judiciously alongside generic feedback in a group setting, this common ADHD screener does not appear to affect college students' self-perceptions or cognitive abilities.
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Affiliation(s)
| | - Alexander H Jordan
- 2 McLean Hospital, Belmont, MA, USA.,3 Harvard Medical School, Boston, MA, USA
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14
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Lovett BJ, Bizub AL. Pinpointing Disability Accommodation Needs: What Evidence Is Most Relevant? PSYCHOLOGICAL INJURY & LAW 2019. [DOI: 10.1007/s12207-019-09341-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Li-Tsang CWP, Li TMH, Lau MSW, Lo AGW, Ho CHY, Leung HWH. Computerised Handwriting Speed Test System (CHSTS): Validation of a handwriting assessment for Chinese secondary students. Aust Occup Ther J 2018; 66:91-99. [PMID: 30548273 DOI: 10.1111/1440-1630.12526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND/AIM Handwriting difficulties can be detrimental to students' performance in school tests and even in public examinations. It is crucial for school-based occupational therapists to identify students with handwriting difficulties and support them with appropriate adaptive strategies. The purpose of this study is to validate a computerised assessment - the Computerised Handwriting Speed Test System (CHSTS) of both Chinese and English handwriting for Chinese secondary students and provide an objective reference for extra time allowance in paper-based examinations. METHODS The internal consistency, test-retest reliability, convergent and discriminant validity of CHSTS were examined using the data from 512 typically developing students and 64 students with special educational needs (SEN) in Hong Kong mainstream secondary schools. RESULTS Handwriting performance of senior students was better than that of junior students. High internal consistency was shown by over 0.80 Cronbach's α in all measurement items and over 0.90 item-total correlations in temporal domain items. Intra-class correlation indicated good to excellent test-retest reliability of CHSTS (all P < 0.0001). Principal Component Analysis revealed that four components in CHSTS accounted for over 80% of the variance. Handwriting performance was positively associated with manual coordination, automaticity and oculomotor control (all P < 0.05) in linear regression analyses. Students with SEN could be effectively differentiated from typically developing students (over 75% sensitivity and specificity) based on the CHSTS items. CONCLUSION Validation of CHSTS is the groundwork for identifying students with handwriting difficulties and providing adaptive strategies including fair special examination arrangements for these students.
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Affiliation(s)
- Cecilia W P Li-Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Tim M H Li
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Mandy S W Lau
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Amy G W Lo
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Choco H Y Ho
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.,Department of Computer Science, City University of Hong Kong, Hong Kong, China
| | - Howard W H Leung
- Department of Computer Science, City University of Hong Kong, Hong Kong, China
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The Effect of Neurocognitive Function on Math Computation in Pediatric ADHD: Moderating Influences of Anxious Perfectionism and Gender. Child Psychiatry Hum Dev 2018; 49:822-832. [PMID: 29560540 PMCID: PMC6519456 DOI: 10.1007/s10578-018-0798-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Predictors of math achievement in attention-deficit/hyperactivity disorder (ADHD) are not well-known. To address this gap in the literature, we examined individual differences in neurocognitive functioning domains on math computation in a cross-sectional sample of youth with ADHD. Gender and anxiety symptoms were explored as potential moderators. The sample consisted of 281 youth (aged 8-15 years) diagnosed with ADHD. Neurocognitive tasks assessed auditory-verbal working memory, visuospatial working memory, and processing speed. Auditory-verbal working memory speed significantly predicted math computation. A three-way interaction revealed that at low levels of anxious perfectionism, slower processing speed predicted poorer math computation for boys compared to girls. These findings indicate the uniquely predictive values of auditory-verbal working memory and processing speed on math computation, and their differential moderation. These findings provide preliminary support that gender and anxious perfectionism may influence the relationship between neurocognitive functioning and academic achievement.
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Best Practices in School Mental Health for Attention-Deficit/Hyperactivity Disorder: A Framework for Intervention. SCHOOL MENTAL HEALTH 2018. [DOI: 10.1007/s12310-018-9267-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Capodieci A, Martinussen R. Math Error Types and Correlates in Adolescents with and without Attention Deficit Hyperactivity Disorder. Front Psychol 2017; 8:1801. [PMID: 29075227 PMCID: PMC5641671 DOI: 10.3389/fpsyg.2017.01801] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 09/28/2017] [Indexed: 11/13/2022] Open
Abstract
Objective: The aim of this study was to examine the types of errors made by youth with and without a parent-reported diagnosis of attention deficit and hyperactivity disorder (ADHD) on a math fluency task and investigate the association between error types and youths’ performance on measures of processing speed and working memory. Method: Participants included 30 adolescents with ADHD and 39 typically developing peers between 14 and 17 years old matched in age and IQ. All youth completed standardized measures of math calculation and fluency as well as two tests of working memory and processing speed. Math fluency error patterns were examined. Results: Adolescents with ADHD showed less proficient math fluency despite having similar math calculation scores as their peers. Group differences were also observed in error types with youth with ADHD making more switch errors than their peers. Conclusion: This research has important clinical applications for the assessment and intervention on math ability in students with ADHD.
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Affiliation(s)
- Agnese Capodieci
- Department of General Psychology, University of Padova, Padova, Italy
| | - Rhonda Martinussen
- Department of Human Development and Applied Psychology, University of Toronto, Toronto, ON, Canada
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Weis R, Till CH, Erickson CP. ADHD Assessment in College Students: Psychologists’ Adherence to DSM-5 Criteria and Multi-Method/Multi-Informant Assessment. JOURNAL OF PSYCHOEDUCATIONAL ASSESSMENT 2017. [DOI: 10.1177/0734282917735152] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The evidence-based assessment of attention-deficit/hyperactivity disorder (ADHD) depends on adherence to Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) diagnostic criteria and reliance on multi-method/multi-informant data. Although nearly all psychologists endorse these practices, college students with ADHD may lack documentation supporting their diagnoses. We reviewed the documentation submitted by 214 undergraduates diagnosed with ADHD and receiving academic accommodations for this condition. Their clinicians also completed a checklist that described their assessment procedures. Relatively few psychologists assessed all DSM-5 criteria, based on either the psychologist’s self-reported assessment procedures (23.4%), written documentation (14.0%), or multi-method/multi-informant data (10.3%) such as educational/medical records, results of rating scales, or interviews with other informants. Psychologists were least likely to assess students’ areas of impairment or to rule out alternative causes for students’ self-reported symptoms. This lack of adherence to DSM-5 criteria and overreliance on students’ self-reports can threaten the reliability of diagnosis and the appropriateness of medication and accommodations that follow.
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20
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Canu WH, Elizondo M, Broman-Fulks JJ. History of ADHD traits related to general test and specific math anxiety in college students. LEARNING AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.lindif.2017.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Weis R, Erickson CP, Till CH. When Average Is Not Good Enough: Students With Learning Disabilities at Selective, Private Colleges. JOURNAL OF LEARNING DISABILITIES 2016; 50:684-700. [PMID: 27222490 DOI: 10.1177/0022219416646706] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Adolescents with learning disabilities disproportionately come from lower socioeconomic status backgrounds, show normative deficits in academic skills, and attend 2-year, public colleges instead of 4-year institutions. However, students with learning disabilities are well represented at the United States' most expensive and selective postsecondary institutions. We examined the psychoeducational functioning of students receiving accommodations for learning disabilities at a private, selective, liberal arts college. We also determined whether students had objective evidence supporting their disability diagnoses and academic accommodations. Most students showed above-average cognitive abilities, average academic skills, and no evidence of impairment. Although nearly all students reported academic problems, most lacked objective evidence of academic difficulties prior to college as well as relative or normative deficits in broad academic skills or fluency. Results indicate a need for greater reliance on objective, multimethod/multi-informant data in the diagnostic process. Results also highlight limitations in the current professional guidelines for documentation decision making in higher education.
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Tosto MG, Momi SK, Asherson P, Malki K. A systematic review of attention deficit hyperactivity disorder (ADHD) and mathematical ability: current findings and future implications. BMC Med 2015; 13:204. [PMID: 26315934 PMCID: PMC4552374 DOI: 10.1186/s12916-015-0414-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 06/30/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Several recent behavioural and behavioural genetic studies have investigated the relationship between attention deficit hyperactivity disorder (ADHD) and mathematical ability. The aim of this systematic review was to provide an overview of these studies to date. An emphasis was placed on reviewing results that explored the association between mathematics and the two ADHD components of attention and hyperactivity-impulsivity separately. METHODS A systematic search of quantitative studies investigating the association between mathematics and ADHD was conducted across five databases (PsychINFO, Web of Science, PubMed, EMBASE, and Scopus). A total of 30 cross-sectional and four longitudinal studies were included in this review. RESULTS Narrative synthesis of the results was provided using PRISMA guidelines. Taken together, the studies pointed at substantial evidence for a negative association between ADHD symptoms and mathematical ability. This association was particularly marked for the inattentive component of ADHD than for the hyperactive-impulsive component. Evidence from twin studies also showed a significant genetic correlation between mathematics and ADHD, which was greater for the inattentive component of ADHD compared to the hyperactive-impulsive component. CONCLUSIONS The differential relationship of the hyperactivity-impulsivity and inattention domains with mathematics emphasises the heterogeneity within the disorder and suggests a partially different aetiology of the two ADHD domains. A better understanding of the aetiology of ADHD could help develop more efficient interventions aimed at the reduction of its symptoms. It could also offer an explanatory framework for shortcomings in achievement and inform the development of non-pharmacological intervention strategies.
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Affiliation(s)
- Maria Grazia Tosto
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre (SGDP), Institute of Psychiatry, Psychology & Neuroscience (IoPPN), (PO80), De Crespigny Park, Denmark Hill, London, SE5 8AF, UK. .,Laboratory for Cognitive Investigations and Behavioural Genetics, Tomsk State University, Tomsk, Russia.
| | - Sukhleen Kaur Momi
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre (SGDP), Institute of Psychiatry, Psychology & Neuroscience (IoPPN), (PO80), De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.
| | - Philip Asherson
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre (SGDP), Institute of Psychiatry, Psychology & Neuroscience (IoPPN), (PO80), De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.
| | - Karim Malki
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre (SGDP), Institute of Psychiatry, Psychology & Neuroscience (IoPPN), (PO80), De Crespigny Park, Denmark Hill, London, SE5 8AF, UK. .,Laboratory for Cognitive Investigations and Behavioural Genetics, Tomsk State University, Tomsk, Russia.
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Lindstrom W, Nelson JM, Foels P. Postsecondary ADHD Documentation Requirements: Common Practices in the Context of Clinical Issues, Legal Standards, and Empirical Findings. J Atten Disord 2015; 19:655-65. [PMID: 24131894 DOI: 10.1177/1087054713506262] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the information postsecondary institutions require when determining disability service eligibility for students with reported ADHD. METHOD ADHD documentation requirements of 200 U.S. institutions were surveyed by reviewing guidelines posted on disability services websites. RESULTS Whereas virtually all institutions required documentation, findings revealed significant variability in requirements across institutions. Required variables most often included a qualified evaluator (80%), diagnostic statement (75%), and identification of substantial limitations (73%), but only 5 of 46 evaluated variables were required by at least 50% of institutions. Supportive data such as diagnostic criteria, standardized assessment results, and rationale for accommodations were rarely required. CONCLUSION The majority of institutions required little to verify ADHD as a disability. Furthermore, there was little agreement on what components are essential for verification. When integrated with research, a large portion of guidelines failed to address identified weaknesses in ADHD diagnosis and disability determination.
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Miller LA, Lewandowski LJ, Antshel KM. Effects of Extended Time for College Students With and Without ADHD. J Atten Disord 2015; 19:678-86. [PMID: 23590977 DOI: 10.1177/1087054713483308] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The number of students with a disability requesting test accommodations has been steadily increasing in higher education settings. The present study examined the effects of extra time on the reading comprehension performance of college students with and without ADHD. METHOD A modified version of The Nelson-Denny Reading Test was completed by 38 college students with ADHD and 38 matched controls under three conditions: standard time, time and one half, and double time. RESULTS Groups did not differ in the number of items attempted or correctly answered at standard time, time and one half, or double time. Comparing the ADHD group at extended time to non-ADHD peers at standard time, the ADHD group attempted and answered significantly more test items. CONCLUSION Extra time conferred an advantage to the ADHD group, suggesting that extended time accommodations are not specific and perhaps not necessary for all college students with an ADHD diagnosis.
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Gray SA, Rogers M, Martinussen R, Tannock R. Longitudinal relations among inattention, working memory, and academic achievement: testing mediation and the moderating role of gender. PeerJ 2015; 3:e939. [PMID: 26038714 PMCID: PMC4451022 DOI: 10.7717/peerj.939] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Accepted: 04/16/2015] [Indexed: 11/20/2022] Open
Abstract
Introduction. Behavioral inattention, working memory (WM), and academic achievement share significant variance, but the direction of relationships across development is unknown. The aim of the present study was to determine whether WM mediates the pathway between inattentive behaviour and subsequent academic outcomes. Methods. 204 students from grades 1-4 (49.5% female) were recruited from elementary schools. Participants received assessments of WM and achievement at baseline and one year later. WM measures included a visual-spatial storage task and auditory-verbal storage and manipulation tasks. Teachers completed the SWAN behaviour rating scale both years. Mediation analysis with PROCESS (Hayes, 2013) was used to determine mediation pathways. Results. Teacher-rated inattention indirectly influenced math addition fluency, subtraction fluency and calculation scores through its effect on visual-spatial WM, only for boys. There was a direct relationship between inattention and math outcomes one year later for girls and boys. Children who displayed better attention had higher WM scores, and children with higher WM scores had stronger scores on math outcomes. Bias-corrected bootstrap confidence intervals for the indirect effects were entirely below zero for boys, for the three math outcomes. WM did not mediate the direct relationship between inattention and reading scores. Discussion. Findings identify inattention and WM as longitudinal predictors for math addition and subtraction fluency and math calculation outcomes one year later, with visual-spatial WM as a significant mediator for boys. Results highlight the close relationship between inattention and WM and their importance in the development of math skills.
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Affiliation(s)
- Sarah A Gray
- Ontario Institute for Studies in Education, University of Toronto , Canada
| | | | - Rhonda Martinussen
- Ontario Institute for Studies in Education, University of Toronto , Canada
| | - Rosemary Tannock
- Ontario Institute for Studies in Education, University of Toronto , Canada ; Research Institute of the Hospital for Sick Children , Canada
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Abstract
OBJECTIVE To investigate the relationship between ADHD symptoms, executive functioning problems, and benefit from extended time testing accommodations. METHOD College students completed a battery of measures assessing processing speed and reading fluency, reading comprehension (under two different time limits), symptoms of ADHD, executive functioning deficits, and perceptions of need for extended time. RESULTS Students reporting more symptoms of ADHD and executive functioning deficits actually benefited less from extended time, and students' perceptions of their timing needs did not predict benefit. CONCLUSION Students with more ADHD symptoms are less likely to use extended time effectively, possibly because of their associated executive functioning problems. These results suggest there may be little justification for examining a student's ADHD symptoms when making extended time accommodation decisions.
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Lovett BJ, Lewandowski LJ, Berger C, Gathje RA. Effects of Response Mode and Time Allotment on College Students' Writing. ACTA ACUST UNITED AC 2014. [DOI: 10.1080/10790195.2010.10850331] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Prevalence and Characteristics of School Services for High School Students with Attention-Deficit/Hyperactivity Disorder. SCHOOL MENTAL HEALTH 2014; 6:264-278. [PMID: 25506403 DOI: 10.1007/s12310-014-9128-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study examines the prevalence and characteristics of services reported by school staff for 543 high school students participating in the 8 year follow-up of the multi-site Multimodal Treatment study of ADHD (MTA). Overall, 51.6% of students with a history of attention-deficit/hyperactivity disorder (ADHD) were receiving services through an Individualized Educational Plan (IEP) or a 504 plan, a rate higher than expected for this age group. Less than 5% of these had 504 plans; 35.5% attended special education classes. Very few services (except tutoring) were provided outside of an IEP or 504 plan. Almost all students with services received some type of academic intervention, whereas only half received any behavioral support or learning strategy. Less than one-fourth of interventions appear to be evidence-based. Students receiving services showed greater academic and behavioral needs than those not receiving services. Services varied based upon type of school, with the greatest number of interventions provided to students attending schools that only serve those with disabilities. Original MTA treatment randomization was unrelated to services, but cumulative stimulant medication and greater severity predicted more service receipt. Results highlight a need for accommodations with greater evidence of efficacy and for increased services for students who develop academic difficulties in high school.
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Zentall SS, Tom-Wright K, Lee J. Psychostimulant and sensory stimulation interventions that target the reading and math deficits of students with ADHD. J Atten Disord 2013; 17:308-29. [PMID: 22286108 DOI: 10.1177/1087054711430332] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The purpose of this review of students with attention deficit hyperactivity disorder (ADHD) was to summarize the following: (1) academic deficits in math and reading, (2) possible theoretical contributors to these deficits, and (3) psychostimulant interventions that target math and reading, as well as, parallel interventions involving sensory stimulation. METHOD A comprehensive examination of the literature was conducted on children with ADHD with and without co-occurring disabilities, summarizing their reading and math achievement and the effects of psychostimulant and sensory stimulant interventions on these academic areas. RESULTS Students without co-occurring disabilities (ADHD-) had fewer deficits in reading than in math and than students with co-occurring disabilities (ADHD+). Furthermore, students with ADHD+ demonstrated greater responsiveness to psychostimulants through improved reading recognition and math calculations, with limited gains in literal reading comprehension. Added sensory stimulation produced differential gains for both groups in reading recognition and comprehension and in math calculations and problem solving. CONCLUSION The efficacy of psychostimulants was documented on specific areas of achievement for the ADHD+ group, but this review did not support the administration of psychostimulants for students with ADHD-. For both groups of students, differential gains, losses, and habituation were documented in response to sensory stimulation for both subareas within reading and math, which were interpreted as support for the optimal stimulation theory.
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Lewandowski L, Cohen J, Lovett BJ. Effects of Extended Time Allotments on Reading Comprehension Performance of College Students With and Without Learning Disabilities. JOURNAL OF PSYCHOEDUCATIONAL ASSESSMENT 2012. [DOI: 10.1177/0734282912462693] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Students with disabilities often receive test accommodations in schools and on high-stakes tests. Students with learning disabilities (LD) represent the largest disability group in schools, and extended time the most common test accommodation requested by such students. This pairing persists despite controversy over the validity of extended time as a test accommodation. The current study examined the effects of 50% and 100% time extensions on the reading comprehension performance of college students with and without LD. Results indicated that typical students actually benefited more than the LD group when given extra time, indicating that extended time is not a test accommodation that is specific to those with a disability. Moreover, when only students with LD were given extended time, especially double time, they outperformed nondisabled peers. We discuss implications of these findings for future research as well as accommodation decisions in educational settings.
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Lewandowski L, Gathje RA, Lovett BJ, Gordon M. Test-Taking Skills in College Students With and Without ADHD. JOURNAL OF PSYCHOEDUCATIONAL ASSESSMENT 2012. [DOI: 10.1177/0734282912446304] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
College students with attention deficit hyperactivity disorder (ADHD) often request and receive extended time to complete high-stakes exams and classroom tests. This study examined the performances and behaviors of college students on computerized simulations of high-stakes exams. Thirty-five college students with ADHD were compared to 185 typical peers on measures of reading decoding, speed, vocabulary, comprehension, test strategies, time management, and test anxiety. Results indicated no differences between students with and without ADHD on various reading (decoding, speed, vocabulary, and comprehension) and test-taking variables (time utilization, navigation style, or strategy use), yet significant differences were present regarding their perceptions of, and anxiety during, test taking. It appears that students with ADHD perform similarly to peers on timed reading tests, although they think they perform less well and worry more about their performance.
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Kercood S, Zentall SS, Vinh M, Tom-Wright K. Attentional cuing in math word problems for girls at-risk for ADHD and their peers in general education settings. CONTEMPORARY EDUCATIONAL PSYCHOLOGY 2012. [DOI: 10.1016/j.cedpsych.2012.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Eiraldi RB, Mautone JA, Power TJ. Strategies for implementing evidence-based psychosocial interventions for children with attention-deficit/hyperactivity disorder. Child Adolesc Psychiatr Clin N Am 2012; 21:145-59, x. [PMID: 22137818 PMCID: PMC3233687 DOI: 10.1016/j.chc.2011.08.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
An extensive amount of research has demonstrated the effectiveness of psychosocial interventions for children with ADHD. Historically, the research has focused on interventions targeting problems in the home or school setting, but more recent research has highlighted the importance of family – school partnerships and conjoint approaches to intervention involving family and school. Effective approaches to psychosocial intervention consist of strategies to address performance deficits, promote adaptive behavior, and improve children’s self-control and academic and social skills. Considerable evidence exists to indicate that combined approaches are more effective in reducing ADHD symptoms and related academic and social impairments than separate treatments.
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Affiliation(s)
- Ricardo B Eiraldi
- Department of Pediatrics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.
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Lewandowski LJ, Lovett BJ, Rogers CL. Extended Time as a Testing Accommodation for Students With Reading Disabilities. JOURNAL OF PSYCHOEDUCATIONAL ASSESSMENT 2008. [DOI: 10.1177/0734282908315757] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Testing accommodations have become a common component of services for students with disabilities at all levels of education. This study examined the effect of a common testing accommodation—extended time—on the reading comprehension test performance of high school students. Sixty-four students, half of whom had learning disabilities (LDs) in the area of reading, were given the Nelson Denny Reading Comprehension subtest under various time conditions. Nondisabled students benefited more from the extended time than students with LDs did. However, extended time did allow students with LDs to attempt as many questions as their nondisabled peers did under standard time conditions. Implications for future research, as well as policy in this area are discussed.
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