Documentation Guidelines: Tic Disorders or Tourette's

To receive accommodations for College Board exams, students with tic disorders or Tourette's 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 tic disorder as diagnosed. The diagnosis should be made by someone with appropriate professional credentials, should 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 disabilities change over time, documentation should be up to date. In most cases of tic disorder, the evaluation updates should be no more than one year old. Include the initial evaluation, if appropriate, and a full description of the student’s current symptoms.

  3. History should be presented.

    Provide relevant educational, developmental, and medical history in support of the diagnosis of tic disorder and 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, including:

    • Historical information about the onset of the impairment.
    • A description of the student's current abilities.
    • The impact of in-school accommodations on the student’s performance.
    • The student’s response to medication and other interventions.
    • 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 medical note is usually not sufficient to support the need for accommodations. The symptoms and needs of students with Tourette’s or other tic disorders vary greatly among individuals. Documentation should describe the student’s symptoms in detail and support the need for the specific accommodations requested. Please include a detailed description of the student’s current tics, including their frequency, duration, and severity.

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

  5. Functional limitations should be described.

    Explain how the tic 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? The following should also be provided:

    • Detailed information from the student’s treatment provider regarding frequency, duration, and intensity of current symptoms
    • Current medication regimen and its effect on the student's disability and ability to take College Board tests
    • Evidence of impairment in the academic setting, particularly when performing tasks relevant to College Board exams (e.g., reading, mathematical calculation, and written expression) such as a psychoeducational evaluation.
    • Descriptive information from the school, such as teacher observations, which can be recorded on the Teacher Survey Form.
  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
    • 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 of tic disorders and Tourette’s syndrome, evaluators must be licensed by the state in which they practice.