Documentation Guidelines: Psychiatric Disorders

To receive accommodations for College Board exams, students with psychiatric disorders 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 psychiatric disorder as diagnosed. The diagnosis should be made by someone with appropriate professional credentials, be specific, and reference the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 or whichever edition was current at the time of diagnosis).

  2. All information should be current.

    Because psychiatric disabilities can change over time, documentation should be up to date and include:

    • A current psychiatric update, completed within the past year, if the initial diagnosis is more than one year old
    • The initial evaluation in which the disorder was diagnosed

    The update should describe the current impact of the student's disability on participation in College Board exams. It does not need to be a full evaluation or be conducted by the initial evaluator.

  3. History should be presented.

    Provide relevant educational, developmental, and medical history in support of the psychiatric diagnosis and functional limitations. 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, including:

    • Historical information about the onset of the impairment.
    • The student’s response to medication and other interventions.
    • School records and logs.
    • Teacher observations of the student’s disability during class, its impact on school-based testing, and the student’s use of accommodations. You may want to use the Teacher Survey Form.
  4. The diagnosis should be supported by testing.

    A note from your treatment provider or evaluator is usually not sufficient to support the need for accommodations. Documentation should describe the student’s symptoms in detail and support the need for the specific accommodations requested, including:

    • Psychiatric evaluation, including a summary of the assessment procedures and results
    • Full description of current symptoms from the current mental health treatment provider, including symptom frequency, duration, and intensity
    • Psychoeducational or neuropsychological evaluation is sometimes required (Include test scores and narrative summary.)

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

  5. Functional limitations should be described.

    Explain how the psychiatric disorder impacts the student’s academic functioning and ability to participate in College Board exams. For example: How frequent are the student’s symptoms? How do they impact the student in and out of school? When is the student impacted?

    In most cases, anxiety about test taking by itself is not a psychiatric disorder and does not qualify a student for accommodations.

    Functional limitation can be documented in a variety of ways:

    • Psychoeducational evaluations, including standardized test scores and narrative. Use national norms to support both the diagnosis and functional limitation.
    • Descriptive information from the school, such as teacher observations, which can be recorded on the Teacher Survey Form.
    • Current medication regimen and its effect on the student's disability and ability to take College Board tests.
  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 the requested accommodations.
    • A detailed description of the student’s current symptoms, including frequency, duration, and intensity, could be helpful.
    • Current academic needs of the student, including functional impairments and use of accommodations in school.

    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.