Documentation Guidelines: Head Injuries

To receive accommodations for College Board exams, students with head injuries must make a request to College Board’s Services for Students with Disabilities (SSD)—even if they have an Individualized Education Plan (IEP), a 504 plan, or already receive those accommodations for school or state tests.

All requests should meet seven key criteria.


  1. The diagnosis should be clearly stated.

    Documentation should state the specific head injury as diagnosed. Provide a full description of the injury, including answers to these questions:

    • How was the student injured?
    • What was the date of injury?
    • Which area was affected? (Provide the site of the lesion, bleed, etc.)
    • In the case of concussions with long-standing sequelae, did the student lose consciousness? If so, for how long?

    The diagnosis should be made by someone with appropriate professional credentials, should be specific, and when appropriate, should relate the disability to professional standards.

  2. All information should be current.

    Many head injuries heal over time and accommodation needs may change as the impact of head injuries on brain functioning changes. It is important to provide the most up-to-date information in addition to information about the original injury. Concussions often have a normal course of recovery; therefore, documentation should include symptom progression during and after the recovery phase, per best practice.

  3. History should be presented.

    Provide relevant educational, developmental, and medical history in support of the head injury diagnosis and the functional limitation. Information about the student’s history of receiving school accommodations and current use of accommodations helps College Board understand the nature and severity of the student’s disability and the need for accommodations. Teacher observations are often helpful as well; they can be recorded on the Teacher Survey Form.

  4. The diagnosis should be supported by testing.

    A medical note is usually not sufficient to support the need for accommodations. Documentation should demonstrate that a comprehensive assessment was conducted and include:

    • Copies of test results used to evaluate the injury, including the area affected (i.e., site of the lesion, bleed, etc.)
    • A summary of neuropsychological, cognitive, and achievement testing, including standardized test scores and narrative. Please provide standard and scaled test scores and percentiles for all subtests
    • A description of current/residual symptoms (including their frequency, intensity, and duration)
    • Detailed medical information relating to the student's needs, including the effect of medication or treatment on the student's disability

    Consult our page on commonly used diagnostic tests for frequently used assessments.

  5. Functional limitations should be described.

    Explain how the head injury currently impacts the student’s daily functioning and ability to participate in College Board exams. Functional limitation can be documented in a variety of ways:

    • Neuropsychological or comprehensive cognitive and academic evaluations, including standardized test scores and narrative. Use national norms to support both the diagnosis and functional limitation.
    • Summary of the student's developmental, educational, and/or medical history.
    • Descriptive information from the school, such as teacher observations, which can be recorded on the Teacher Survey Form.
    • Speech and language, visual, or occupational therapy evaluations, where applicable.
  6. Recommended accommodations should be justified.

    Provide a detailed rationale for the requested accommodations, focusing on:

    • The connection between the student’s diagnosed disability and requested accommodations
    • The current academic needs of the student, including functional impairments and use of accommodations in school

    For example, students requesting extended time should document difficulty taking timed tests and include current scores on timed and untimed or extended time tests.

    Students requesting an accommodation for recording responses should document any visual, fine-motor and/or visual-motor integrations problems and the impact they have on writing.

    See documentation guidelines for frequently requested accommodations for requirements specific to extended time, breaks, reading and seeing accommodations, recording responses, use of a four-function calculator, and assistive technology.

  7. Evaluators' professional credentials should be listed.

    To ensure valid testing and diagnosis, evaluators must be licensed by the state in which they practice. Appropriate evaluators include:

    • Neurologists, psychiatrists, and other licensed physicians
    • Psychologists/educational diagnosticians
    • Neuropsychologists