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Do post-secondary students with ASD process information more slowly than others? Implications for accommodations of extra time (PDF 214KB)

Beth Pollock, Nathaniel Davin, Dylan Kwan, Kieran Bodner, & Allyson G. Harrison (2026)

Abstract 

Given the frequency with which students with Autism Spectrum Disorder (ASD) receive extended time accommodations in post-secondary settings, this study examined whether students with ASD—alone or with comorbid conditions—perform below peers without neurodevelopmental diagnoses on speeded tasks. A total of 729 post-secondary students who completed psychoeducational assessments were divided into four groups: ASD only (n = 56), ASD with Learning Disorder (LD; n = 58), ASD with ADHD and/or mental health conditions (MH; n = 27), and a No Diagnosis (No Dx) group (n = 588). Participants completed a flexible battery of individually administered tests assessing intellectual ability, processing speed, speed of retrieval, efficiency of cognitive flexibility and academic fluency. Overall, students in the ASD groups did not perform significantly below the No Dx group on most speeded cognitive and academic tasks. Further, mean scores on measures of speeded cognitive and academic functioning generally fell in the Average range across study groups. As such, the results did not suggest a need for extended time accommodation based on a diagnosis of ASD alone. The results reinforce the need for performance-based data to understand the diverse cognitive and academic profiles among students with ASD to guide appropriate supports.

Provision of extended assessment time in post‑secondary settings (PDF 694KB)

Allyson G. Harrison, Beth Pollock, & Alana Holmes (2022)

Abstract 

Although extended time for tests and examinations is the most commonly requested and provided accommodation in postsecondary institutions, best practice guidelines from existing research are rarely translated into practice. Thus, a review of the literature was undertaken to examine support for granting additional assessment time to persons in specific disability categories. Based on this review, no more than 25% additional time is supported for students with learning disabilities, and even then, only when their documented area of functional impairment overlaps with assessment task requirements. No research support exists for the provision of extra time for students with attention deficit/hyperactivity disorder (AD/HD) or mental health diagnoses. Research is silent on the appropriateness of additional assessment time for individuals with autism spectrum disorder and thus individuals need to be considered on a case-by-case basis. In very exceptional situations, more than 25% additional time may be warranted, but this would need to be well considered using an established decision-making model.

Memory aids as a disability-related accommodation? Let’s remember to recommend them appropriately (PDF 130KB)

Allyson G. Harrison, Alana Holmes, & Beth Pollock (2021)

Abstract

Memory aids are now frequently provided to elementary and secondary school students to increase their success in achieving provincial curriculum standards. While such an accommodation may meet the immediate goal of improved academic performance it may not be warranted based on an actual long-term memory retrieval impairment and may therefore be inequitable, providing an unfair academic advantage relative to non-disabled students. Furthermore, providing memory aid accommodations inappropriately may rob students of the opportunity to learn effective study and retrieval strategies, leading instead to dependence on an accommodation that may not be continued once they enter post-secondary education. An appropriate accommodation at the post-secondary level of education removes a disability-related barrier (functional impairment) and assists only those facing such barriers; under human rights legislation, accommodations are not implemented to guarantee success, reduce anxiety, or provide unequal access to material. Memory aids improve the retrieval of information from long-term storage for everyone. As such, the current widespread provision of this accommodation prior to post-secondary studies must be evaluated critically, with such supports offered only when justified. A six-step process for determining when memory aids are an appropriate accommodation within the post-secondary setting is provided and discussed.

De-implementing inappropriate accommodations practices (PDF 148KB)

Benjamin J. Lovett & Allyson G. Harrison (2021)

Abstract 

Educational accommodations, which alter the manner in which instruction or assessments are administered, are often an appropriate part of a student’s academic program. However, accommodations are frequently overused and have significant limitations. De-implementing inappropriate accommodations is a complex task, but one made easier through a clear understanding of the factors that cause and maintain those accommodations practices. In the present paper, we use the logic of functional behavioral assessment to better understand why evaluators and school staff recommend and provide inappropriate accommodations. We identify problematic background beliefs, specific antecedents, and reinforcing consequences for inappropriate accommodations, before describing several effective strategies for de-implementing those accommodations.

Learning disability documentation submitted by osteopathic medical students (PDF 1.2MB)

Allyson G. Harrison, Benjamin J. Lovett, Shelby Keiser, & Irene T. Armstrong (2019)

Abstract 

An increasing number of individuals are requesting disability accommodations on high- stakes licensing examinations, and neuropsychological evaluation reports are a frequent component of disability documentation. This study reviewed 103 requests for accommodations based on a learning disability (LD), submitted to the National Board of Osteopathic Medical Examiners between 2013 and 2016 for accommodation on the licensure exams for osteopathic physicians. Depending on criteria employed, anywhere from 84 to 97% of applicants failed to meet recognized criteria for a LD diagnosis, with the vast majority demonstrating academic functioning that was average or better relative to most other individuals in the general population. Thus, although given a disability diagnosis, the majority lacked evidence of substantial impairment that would require accommodations under the Americans with Disabilities Act. Additionally, no significant differences were found between the academic achievement or fluency scores of those requesting 50% as compared to 100% extra time. Finally, many evaluators employed grade-based assessment measures to demonstrate academic impairment, even when candidates’ functioning using age-based comparisons was unimpaired. Recommendations for future research and practice based on these and other findings are discussed.

ADHD documentation for students requesting accommodations at the postsecondary level (PDF 153KB)

Allyson G. Harrison & Yontanan Rosenblum (2010)

Abstract 

OBJECTIVE: To update primary health care providers on the guidelines and standards for documentation of attention deficit hyperactivity disorder (ADHD) at the postsecondary level.

QUALITY OF EVIDENCE: We synthesized information from consultations with other experts at postsecondary disability offices and from relevant research in this area (specifically, PsycLIT, PsychINFO, and MEDLINE databases were searched for systematic reviews and meta-analyses from January 1990 to June 2009). Most evidence included was level III.

MAIN MESSAGE: Symptoms of ADHD can occur for many reasons, and primary health care providers need to be cautious when making this diagnosis in young adults. Diagnosis alone is not sufficient to guarantee academic accommodations. Documentation of a disability presented to postsecondary-level service providers must address all aspects of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, criteria for diagnosis of ADHD, and must also clearly demonstrate how recommended academic accommodations were objectively determined.

CONCLUSION: Students with ADHD require comprehensive documentation of their disabilities to obtain accommodations at the postsecondary level. Implementing the guidelines proposed here would improve access to appropriate services and supports for young adults with ADHD, reduce the risk of misdiagnosis of other psychological causes, and minimize the opportunity for students to obtain stimulant medications for illicit use.

Determining cutoff scores on the Conners’ Adult ADHD Rating Scales that can definitively rule out the presence of ADHD in a clinical sample (PDF 1.4MB)

Dylan Kwan, Nathaniel Davin, Allyson G. Harrison, & Sienna Gillie (2026)

Abstract 

In recent years, the prevalence of Attention Deficit/Hyperactivity Disorder (ADHD) and the number of individuals seeking ADHD assessments has risen significantly, leading to an increased demand for accurate diagnostic tools. This study aimed to identify cutoff scores on the Conners’ Adult ADHD Rating Scales (CAARS-S:L) that can definitively rule out the presence of ADHD. Among 102 clinically diagnosed adult ADHD participants and 448 non-ADHD participants who completed the CAARS-S:L, a receiver operating characteristic curve analysis established a perfectly discriminant cutoff T-score of <44 on the ADHD Symptoms Total subscale when looking at any ADHD diagnosis and <54 on the Inattentive Symptoms subscale when looking at individuals diagnosed with the inattentive subtype of ADHD. Alternative cutoffs of <54 (ADHD Symptoms Total subscale) and <63 (Inattentive Symptoms subscale) were also identified, both with a sensitivity of 0.95 or higher. Furthermore, the analysis found the ADHD Index to be a poor predictor of a negative ADHD diagnosis, suggesting against the use of this scale for cutoff determination. Despite this limitation, these findings indicate that with specific cutoffs, the CAARS-S:L may have the potential to conclusively rule out ADHD, effectively streamlining the diagnostic process and reducing unnecessary comprehensive assessments in clear negative cases.

Changes in validity test scores after COVID: Reflection of general distress or something else? (PDF 1.9MB)

Allyson G. Harrison, Nathaniel Davin & Emma Jamieson (2026)

Abstract 

Objective: This study examined whether rates of symptom and performance validity test (SVT, PVT) failure among assessment-seeking postsecondary students changed during and after the COVID-19 pandemic relative to pre-pandemic levels, and whether such changes co-occurred with increased general psychological distress (GPD). Method: Archival data were analyzed from 1076 students assessed for possible attention-related disorders between 2018 and 2024 at a regional university-based assessment center. Participants completed multiple symptom and performance validity measures, a self-report measure of Attention-Deficit/Hyperactivity Disorder (ADHD), and a higher-order measure of general psychological distress. Students were grouped by assessment timing: pre-COVID (2018–March 1, 2020), during COVID (March 2, 2020–August 2022), or post-COVID (September 2022–September 2024). Results: Failure rates on most PVTs did not differ significantly across time periods, indicating overall stability in performance validity, with one dyslexia-related validity measure showing higher failure rates post-COVID. On a personality assessment, students assessed during and after COVID reported significantly higher Negative Impression Management scores, lower Positive Impression Management scores, and greater GPD. Rates of severe GPD increased from 23% pre-COVID to 38% during and after COVID. Failure on ADHD-specific SVTs also increased significantly post-COVID, indicating higher rates of non-credible ADHD symptom reporting despite stable performance validity. Discussion: Since the onset of COVID-19, postsecondary students have demonstrated heightened psychological distress alongside increased non-credible self-reporting, particularly for ADHD symptoms. These findings reflect parallel trends rather than a direct causal relationship and underscore the importance of incorporating both symptom and performance validity testing when interpreting self-reported symptoms in clinical and psychoeducational assessments.

Measurement of working memory on the Wechsler Adult Intelligence Scale: Should we subtract arithmetic? (PDF 826KB)

Allyson G. Harrison, A. Lynne Beal, Irene T. Armstrong, & Anna Gallagher (2024)

Abstract

Deficits in working memory are often used as evidence to support the diagnosis of a neuropsychological disorder or acquired brain injury. Subtests that comprise the working memory index (WMI) of the WAIS-IV are assumed to all measure the same construct; however, deficits in basic arithmetic skills may unduly influence performance on the Arithmetic subtest, particularly among students with neurodevelopmental disabilities. The current study examined the relationship between working memory scores and measured mathematical ability in a sample of 605 postsecondary students seeking psychoeducational assessments to verify their need for academic accommodation. Different combinations of the three WAIS-IV working memory subtests’ scores resulted in significantly different composite WMI scores. Across diagnostic groups, subtest scores were highest on Letter-Number Sequencing and Digit Span and lowest on Arithmetic. Furthermore, math achievement scores were more strongly correlated with Arithmetic scores than with Digit Span or Letter-Number Sequencing scores. Students with learning disabilities performed significantly more poorly on Arithmetic relative to students with attention deficit hyperactivity disorder. Given the risk of clinicians falsely diagnosing a working memory impairment, we therefore advise clinicians to substitute out the Arithmetic subtest, which requires math skills, when evaluating young adults for neurodevelopmental conditions. This will avoid them being falsely identified as having a working memory impairment when in fact their working memory is intact.

In-person and in-home teleneuropsychological assessments with youth with neurodevelopmental disorders: What’s the difference? (PDF 197KB)

Julia Moreau, Beth Pollock, & Allyson G. Harrison (2023)

Abstract

Psychoeducational assessments provide clinicians with the foundation for diagnostic determinations and meaningful recommendations for youth with neurodevelopmental disorders. Due to the COVID-19 pandemic, the field shifted from seeing clients faceto-face (FTF) to conducting evaluations virtually via teleneuropsychology (TNP) in the client’s own home. The current study sought to determine the equivalence of cognitive and achievement scores obtained in the context of FTF versus TNP testing. Nineteen youth with diverse neurodevelopmental disorders completed the Woodcock Johnson-Fourth Edition (WJ-IV). Results suggest generally equivalent results, with the caveat that scores from measures of Fluid Reasoning and Auditory Processing were significantly different across testing modalities. Environmental factors, characteristics of the clients, administration challenges, technical considerations, and practice effects may have contributed to differences in scores. These findings have implications for assessment standardization, case conceptualization, and implementation of recommendations in the school setting when psychoeducational assessments are conducted virtually.

Predictive value of performance validity testing and symptom validity testing in psychoeducational assessment (PDF 1.4MB)

Allyson G. Harrison, A. Lynne Beal, & Irene T. Armstrong (2023)

Abstract

Using archival data from 2463 psychoeducational assessments of postsecondary students we investigated whether failure on either symptom or performance validity tests (SVTs or PVTs) was associated with score differences on various cognitive, achievement, or executive functioning performance measures or on symptom report measures related to mental health or attention complaints. In total, 14.6% of students failed one or more PVT, 33.6% failed one or more SVT, and 41.6% failed at least one validity test. Individuals who failed SVTs tended to have the highest levels of self-reported symptoms relative to other groups but did not score worse on performance-based psychological tests. Those who failed PVTs scored worse on performance-based tests relative to other groups. Failure on at least one PVT and one SVT resulted in both performance and self-reported symptoms suggestive of greater impairment compared with those who passed all validity measures. Findings also highlight the need for domain-specific SVTs; failing ADHD SVTs was associated only with extreme reports of ADHD and executive functioning symptoms while failing mental health SVTs related only to extreme reports of mental health complaints. Results support using at least one PVT and one SVT in psychoeducational assessments to aid in diagnostic certainty, given the frequency of non-credible presentation in this population of postsecondary students.

The ability of self-report methods to accurately diagnose attention deficit hyperactivity disorder (PDF 393KB)

Allyson G. Harrison & Melanie J. Edwards (2023)

Abstract

Objective: To identify and analyze all studies validating rating scales or interview-based screeners commonly used to evaluate ADHD in adults. Method: A systematic literature search identified all studies providing diagnostic accuracy statistics, including sensitivity and specificity, supplemented by relevant articles or test manuals referenced in reviewed manuscripts. Results: Only 20 published studies or manuals provided data regarding sensitivity and specificity when tasked with differentiating those with and without ADHD. While all screening measures have excellent ability to correctly classify non-ADHD individuals (with negative predictive values exceeding 96%), false positive rates were high. At best, positive predictive values in clinical samples reached 61%, but most fell below 20%. Conclusion: Clinicians cannot rely on scales alone to diagnose ADHD and must undertake more rigorous evaluation of clients who screen positive. Furthermore, relevant classification statistics must be included in publications to help clinicians make statistically defensible decisions. Otherwise, clinicians risk inappropriately diagnosing ADHD.

The impact of depression and anxiety on speed of academic performance and retrieval fluency in postsecondary students (PDF 2.1MB)

Allyson G. Harrison, A. Lynne Beal & Irene T. Armstrong (2022)

Abstract 

Objective: This study evaluated the functional effects of severe mental health symptoms on speed of academic performance to assist clinicians and educators in determining whether extra time accommodations are evidence-based for students with such diagnoses. Method: Using archival data from 1476 post-secondary students, we examined the performance of students with existing mental health diagnoses who were also reporting extremely high levels of symptoms. Their performance on timed academic achievement and cognitive processing measures was compared with performance of students with learning disabilities, Attention Deficit Hyperactivity Disorder, and clinical controls. Students failing stand-alone performance validity and/or symptom validity measures were excluded from this investigation. Results: Students diagnosed with anxiety and/or depression did not differ from clinical controls on any timed performance measure, typically performing academic tasks within a normal amount of time. By contrast, those with reading disabilities were typically the slowest on all academic tasks. Conclusion: Across the range of timed tests, students with mental health diagnoses did not show functional impairments in tests with a speed component. As such, they would not typically require increased time to perform speeded academic tasks, but they might require alternative accommodations in their post-secondary programmes in order to participate equally.

What can we learn about performance validity from TOVA response profiles? (PDF 780KB)

Beth Pollock, Allyson G. Harrison, & Irene T. Armstrong (2021)

Abstract 

Given the functional impairments associated with Attention Deficit/Hyperactivity Disorder (AD/HD), a valid diagnosis is important. However, particularly when carried out in adulthood, the diagnostic process can be challenging and is complicated by conclusive evidence that a proportion of individuals referred for evaluation of AD/HD exaggerate or feign their symptoms. Relatively few methods, however, exist to identify such feigning. While continuous performance tests (CPTs) may provide useful information regarding performance validity, the question remains as to whether there are consistent patterns of exaggeration demonstrated by those feigning AD/HD. Thus, this study used cluster analysis to determine whether valid and reliable performance clusters would emerge based on CPT performance. Using archival data from a university-based AD/ HD screening clinic, we investigated the performance of 305 adults on the Test of Variables of Attention (TOVA). Three profiles emerged, including one cluster who demonstrated exceptionally low performance on the TOVA, exceptionally high reports of AD/HD symptomology, and higher rates of failure on symptom and performance validity tests. The implication from our analysis is that this group most likely represents individuals who were exaggerating or magnifying their difficulties. The results reaffirm previous research showing that performance profiles on a continuous performance test can be used as an indicator of credible performance.

The license plate test performance in Canadian adolescents with learning disabilities (PDF 870KB)

Allyson G. Harrison & Irene Armstrong (2020)

Abstract

Accurate identification of symptom exaggeration is essential when determining whether data obtained in pediatric evaluations are valid or interpretable. Performance validity measures identify performance patterns that are implausible if the test taker is investing full effort; however, it is unclear whether or not persons with preexisting cognitive difficulties such as Specific Learning Disabilities (SLD) might be falsely accused of poor test motivation due to actual but impaired reading, processing or memory skills. The purpose of this study was to evaluate the newly developed License Plate Test (LPT) performance in students with identified SLD providing good effort, to examine the influence of severe reading or learning problems on LPT performance. Participants were 29 students with SLDs aged 11–14 years (M¼ 12.1), who completed psycho-educational assessments as part of a transition program to secondary school. Results indicate that recognition memory measures on the LPT were insensitive to cognitive impairments in these children; all students achieved scores of 80% or higher on these tasks. Performance was more variable as test demands of the LPT increased, and the difference between performance on easy and hard subtests was related to greater difficulties with working memory. These results provide preliminary data regarding how children with SLD perform on the LPT, allowing for development of appropriate cut scores to maximize sensitivity and specificity of this test for use with child and adolescent populations.

Comparing age- and grade-based norms on the Woodcock–Johnson III Normative Update (PDF 554KB)

Allyson G. Harrison, Kaitlyn Butt, & Irene Armstrong (2019)

Abstract

There has been a marked increase in accommodation requests from students with disabilities at both the postsecondary education level and on high-stakes examinations. As such, accurate identification and quantification of normative impairment is essential for equitable provision of accommodations. Considerable diversity currently exists in methods used to diagnose learning disabilities, including whether an impairment is normative or relative. This study investigated the impact on impairment classification if grade-based norms were used to interpret identical raw scores compared with age-based norms. Fourteen raw scores distributed equally across the adult range of the Woodcock–Johnson III Normative Update subtests were scored using norms for either age (18-29 years) or grade (13-17). The results indicate that raw scores receive a significantly lower standardized score (and thus percentile ranking) when grade-based norms are used. Furthermore, the difference between age- and grade-based scores increases dramatically as raw scores decrease, and there is a significant interaction between age and grade in the standard scores obtained. This study provides evidence to suggest that using different norms may result in different decisions about diagnoses and appropriate accommodations.

A critical analysis of the Nelson Denny reading Test as a method of identifying reading impairment in adults (PDF 450KB)

Allyson G. Harrison & Kathleen A. Harrison (2019)

Abstract 

Disability-related test accommodations are requested frequently, especially at the postsecondary level and on licensing examinations. Access to such accommodations typically relies on proof of impairment in some area of academic functioning. The Nelson Denny Reading Test (NDRT; Brown, Fishco, & Hanna, 1993a, 1993b) is often employed by clinicians in order to demonstrate the need for extra time accommodation. The NDRT employs grade-based norms, meaning that postsecondary and graduate-level students who take the test are compared not with all of their same-aged peers but rather to a rarefied group of individuals who have achieved equally high levels of education. This leads to a skewed distribution of scores that, in turn, makes otherwise normally functioning individuals appear impaired. Employing the actual normative data from the NDRT, this study investigated the effect that use of such grade-based norms has on ratings of normative and relative impairment. With the same raw score, substantially more individuals would be classified as impaired on a measure of timed reading comprehension when higher grade level norms are applied as compared with norms that represent a broader sample of individuals. These findings demonstrate clearly that grade based norms should not be employed when using the NDRT to determine disability-related normative impairment.

Automatized sequences as a performance validity test? Difficult if you have never learned your ABCs (PDF 774KB)

Allyson G. Harrison & Irene Armstrong (2018)

Abstract 

Accurate identification of symptom exaggeration is essential when determining whether or not data obtained in pediatric evaluations are valid or interpretable. Apart from using freestanding performance validity tests (PVTs), many researchers encourage use of embedded measures of test-related motivation, including the newly developed automatized sequences test (AST). Such embedded measures are based on identification of performance patterns that are implausible if the test taker is investing full effort; however, it is unclear whether or not persons with pre-existing cognitive difficulties such as specific learning disabilities (SLD) might be falsely accused of poor test motivation due to actual but impaired learning of basic sequences. This study examined the specificity of the AST by reviewing performance of 83 SLD adolescents. Anywhere from 22 to 41% of SLD adolescents investing good effort failed one or more of the tasks included in the AST, and those with lower intelligence scores had higher rates of failure. Clinicians should therefore be cautious if using this PVT with individuals who have a documented history of reading, learning, or intellectual problems.

Diagnostic accuracy of the Conners’ Adult ADHD Rating Scale in a postsecondary population (PDF 86KB)

Allyson G. Harrison, Sylvia Nay, & Irene T. Armstrong (2016)

Abstract

Objective: Clinicians frequently rely upon the results of self-report rating scales when making the diagnosis of ADHD; however, little research exists regarding the ability of self-report measures to accurately differentiate ADHD from other disorders. Method: This present study investigated the ability of the Conners’ Adult ADHD Rating Scale (CAARS) to discriminate between 249 postsecondary students with carefully diagnosed ADHD and 507 clinical controls. Results: The overall discriminant validity of the CAARS was 69%, and it had an unacceptably high false positive and false negative rate. At lower prevalence rates, a high score on the CAARS has only a 22% chance of accurately identifying individuals with ADHD. Conclusion: Although the CAARS is an adequate screening measure, it should not be the main method by which a diagnosis is made, as it frequently misidentifies individuals with other psychological complaints as having ADHD. Implications for clinical practice are discussed.

Comparing Canadian and American normative scores on the Wechsler Adult Intelligence Scale-Fourth Edition (PDF 118KB)

Allyson G. Harrison, Irene T. Armstrong, Laura E. Harrison, Rael T. Lange, & Grant L. Iverson (2014)

Abstract

Psychologists practicing in Canada must decide which set of normative data to use for the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV). The purpose of this study was to compare the interpretive effects of applying American versus Canadian normative systems in a sample of 432 Canadian postsecondary-level students who were administered the WAIS-IV as part of an evaluation for a learning disability, attention-deficit hyperactivity disorder, or other mental health problems. Employing the Canadian normative system yielded IQ, Index, and subtest scores that were systematically lower than those obtained using the American norms. Furthermore, the percentage agreement in normative classifications, defined as American and Canadian index scores within five points or within the same classification range, was between 49% and 76%. Substantial differences are present between the American and Canadian WAIS-IV norms. Clinicians should consider carefully the implications regarding which normative system is most appropriate for specific types of evaluations.

AD/HD symptoms in assessment seeking post-secondary students: Has the COVID-19 pandemic made a difference? (PDF 1.4MB)

Emma Jamieson, Beth Pollock, Nathaniel Davin & Allyson G. Harrison (2025)

Abstract 

Objective: Anecdotally, individuals reporting symptoms of Attention Deficit/Hyperactivity Disorder (AD/HD) seem to have increased over the past few years, particularly since the onset of the Coronavirus disease 2019 (COVID-19) pandemic. As such, this study aimed to objectively investigate the validity of this observation. Method: Using archival data from 667 students assessed in a University-based clinic between 2018 and 2024, self-reported AD/HD symptoms on the Conners’ Adult AD/HD Rating Scales - Self-Report: Long Version (CAARS–S:L) were compared across three time periods: pre-COVID (n = 407), during COVID (n = 110), and
post-COVID (n = 150). Results: Results indicate a significant increase in reported symptoms of inattention/memory, impulsivity/emotional lability, DSM-IV inattentive and hyperactive-impulsive symptoms, total AD/HD symptoms, and AD/HD index after the pandemic. Notably, there was a significant increase in problems with self-concept during and after the pandemic, and there were no significant changes in symptoms of hyperactivity/restlessness across all time points. However, the actual rate of diagnosed AD/HD in the sample did not significantly change across these periods. Conclusions: The findings support anecdotal observations and suggest that the pandemic may have exacerbated AD/HD-like symptoms in an assessment-seeking post-secondary population, even among individuals without formal AD/HD diagnoses. Increases in reported AD/HD symptoms may be related to COVID-19 pandemic factors such as heightened stress, disrupted routines, and increased screen time. The results underscore the need for careful diagnostic practices and further research on the impact of environmental factors on AD/HD symptomatology in young adults.

ADHD and anxiety symptoms: Does construct or assessment type matter more? (PDF 211KB)

Thea R. Bucherbeam, Benjamin J. Lovett, & Allyson G. Harrison (2024)

Abstract 

Objective: This study examined the relationships between self-reported ADHD symptoms, self-reported anxiety, and continuous performance test (CPT) performance. Method: 128 postsecondary students referred for clinical evaluation for possible ADHD and related conditions completed the Conners Adult ADHD Rating Scale, the Behavior Assessment Scale for Children, Third Edition, and either of two CPTs. Results: Multiple regression models found that when self-reported anxiety and CPT performance were used to simultaneously predict self-reported ADHD symptoms, CPT performance was not a significant predictor, whereas self-reported anxiety was. This finding was replicated across two different subsamples that took different CPTs. Conclusion: Self-reported anxiety and ADHD symptoms are strongly related, but neither of these variables is significantly related to CPT performance. Implications for clinical practice and future research are discussed.

Processing speed and timed academic skills in children with learning problems (PDF 968KB)

Benjamin J. Lovett, Allyson G. Harrison & Irene T. Armstrong (2022)

Abstract 

Information processing speed is commonly measured in intelligence and neuropsychological testing, and the scores from speed measures are considered in diagnostic and management recommendations for students with academic learning problems. However, this score usage often depends on assumptions about strong relationships between cognitive speed and the ability to perform actual academic tasks under time pressure. The primary purpose of the present study was to test the strength of these relationships empirically. In the present study, children with prior learning disability diagnoses (146 girls and 301 boys, ages 10–14 years old) completed diagnostic batteries that included measures of cognitive speed as well as timed academic skills. The relationships between the two types of measures were often modest (median r ¼ 0.25), and the gap between processing speed and timed academic scores was typically approximately 1 standard deviation. The pattern of relationships suggested that superficial similarity in stimuli and task demands affected the strength of associations. These results suggest that timed academic skills cannot be reliably estimated based on processing speed scores, and there will often be significant gaps between the two. Therefore, making diagnostic judgments (e.g., learning disability diagnoses) or management recommendations (e.g., for extended time testing accommodations) should be based on more direct measures of relevant academic skills.

Assessing adult ADHD: New research and perspective (PDF 607KB)

Benjamin J. Lovett & Allyson G. Harrison (2021)

Article Introduction

It is our pleasure to introduce this special issue of the Journal of Clinical and Experimental Neuropsychology on the assessment of adult ADHD. We present a mix of empirical and review articles covering different aspects of the topic, all of them trying to offer useful guidance to practicing neuropsychologists, while also stimulating further research. Assessing ADHD in adults is challenging, requiring skills and techniques that clinicians may not routinely use when assessing other disorders or age groups (Lovett & Davis, 2017). Not all clinicians agree on how to conduct such assessments, and a substantial proportion report a lack of confidence in their ability to reach accurate diagnostic judgments (e.g., Schneider et al., 2019). Furthermore, clinicians who undertake such assessments rarely ensure that all the DSM-5 diagnostic criteria are verified prior to making this diagnosis, at least in young adults (Nelson & Lovett, 2019; Weis et al., 2019).

In this introductory article, we briefly review what the empirical literature has shown about selected issues regarding adult ADHD assessment. We then turn to the highlights of each of the remaining articles in the special issue, discussing how they add to our knowledge base. Finally, we turn to questions raised by the extant literature (including this issue’s articles) that we believe require more attention from researchers.

Understanding the biological basis of dyslexia at a neural systems level (PDF 1294KB)

Noor Z. Al Dahhan, John R. Kirby, Donald C. Brien, Rina Gupta, Allyson Harrison & Douglas P. Munoz (2020)

Abstract 

We examined the naming speed performance of 18 typically achieving and 16 dyslexic adults while simultaneously recording eye movements, articulations and fMRI data. Naming speed tasks, which require participants to name a list of letters or objects, have been proposed as a proxy for reading and are thought to recruit similar reading networks in the left hemisphere of the brain as more complex reading tasks. We employed letter and object naming speed tasks, with task manipulations to make the stimuli more or less phonologically and/or visually similar. Compared to typically achieving readers, readers with dyslexia had a poorer behavioural naming speed task performance, longer fixation durations, more regressions and increased activation in areas of the reading network in the left-hemisphere. Whereas increased network activation was positively associated with performance in dyslexics, it was negatively related to performance in typically achieving readers. Readers with dyslexia had greater bilateral activation and recruited additional regions involved with memory, namely the amygdala and hippocampus; in contrast, the typically achieving readers additionally activated the dorsolateral prefrontal cortex. Areas within the reading network were differentially activated by stimulus manipulations to the naming speed tasks. There was less efficient naming speed behavioural performance, longer fixation durations, more regressions and increased neural activity when letter stimuli were both phonologically and visually similar. Discussion focuses on the differences in activation within the reading network, how they are related to behavioural task differences, and how progress in furthering the understanding of the relationship between behavioural performance and brain activity can change the overall trajectories of children with reading difficulties by contributing to both early identification and remediation processes.

Diagnostic implications of the double deficit model for young adolescents with dyslexia (PDF 209KB)

Allyson G. Harrison & Matthew Stewart (2019)

Abstract

Considerable support exists for both the phonological core deficit and the naming speed deficit models of dyslexia. The double deficit model proposed that many students with dyslexia might also be impaired in both underlying processes. Employing either performance thresholds (i.e., scores below the 16th or 25th percentile) or k-means clustering as classification methods, the current study investigated whether 154 young adolescents with dyslexia could be categorized into subtypes according to the presence or absence of phonological deficits alone, naming speed deficits alone, or a combination of the two and whether group composition changed depending on classification method. Results support the existence of both single and double deficit groups and confirm that those with both deficits are the most severely impaired across multiple measures. Contrary to previous research, most adolescents were classified as either naming speed only (about a third of the group) or double deficit when defining impairment using performance thresholds to classify groups. This may suggest that although early phonological deficits are amenable to remediation, identification of language symbols fails to become automatized in most individuals with dyslexia and may require more targeted intervention. Classification differences reported in the literature may depend on age and methods employed for classification.

Comparison of the neurocognitive profiles of individuals with elevated psychotic or depressive symptoms (PDF 523KB)

Michael Grossman, Michael W. Best, Allyson G. Harrison & Christopher R. Bowie (2017)

Abstract 

Aim: Neurocognitive deficits are pervasive and enduring features of severe mental illness that appear before the onset of clinical symptoms and contribute to functional disability. However, it remains unclear how individuals who display warning signs for psychotic or mood disorders compare on their neurocognitive profiles since previous studies have separately examined neurocognition in both groups. Therefore, the purpose of this study was to directly compare performance on a range of neurocognitive tasks in individuals with emerging psychotic or mood symptoms.

Methods: Participants were drawn from a database of individuals who completed a comprehensive assessment at a university-based assessment centre. We examined 3 groups: individuals who endorsed elevated psychotic symptoms (EPS; n = 64), individuals who endorsed elevated depressive symptoms (EDS; n = 58), or non-clinical comparisons (NCC; n = 57) without any elevated psychiatric symptoms or diagnoses.

Results: EPS participants performed worse than NCC and EDS groups on verbal comprehension, working memory and cognitive flexibility, and worse than NCC, but not EDS, on perceptual reasoning. There were no significant differences between groups on processing speed, verbal fluency and set-shifting. EDS performed worse than both EPS and NCC groups on psychomotor speed. Dimensionally, poorer cognitive functioning was more strongly related to EPS than depressive symptoms.

Conclusions: These findings highlight the distinct yet overlapping neurocognitive profiles of both groups with emerging psychiatric symptoms, and suggest that, despite having no formal diagnosis, individuals with EPS exhibit observable cognitive impairment and may still benefit from interventions within academic and workplace contexts.

Clinical, ethical, and forensic implications of a flexible threshold for LD and ADHD in postsecondary settings (PDF 542KB)

Allyson G. Harrison (2017)

Abstract 

Specific learning disabilities (SLD) and attention deficit hyperactivity disorder (ADHD) are lifelong neurologically based disorders diagnosed using objective and specific criteria. Evaluation of current practices indicates that many clinicians employ flexible thresholds for making these diagnoses, at least when evaluating young adults. Given that academic accommodations can provide significant competitive advantages and that students with these diagnoses may qualify for substantial government-funded subsidies and benefits, issues of fairness arise if the objective and research-informed criteria for making these diagnoses are not upheld. This paper investigates the extent to which flexible thresholds are being employed in these diagnoses and the clinical, ethical, and forensic implications that result if clinical standards are not upheld. Recommendations for improved training of professional are provided.

Regional Assessment and Resource Centre (RARC) On-Line to Success (OLTS) Evaluation Report (PDF 340KB)

Emma Peddigrew, Jenna Mackenzie, Tasmia Hai, & Beth Pollock (2026)

Executive Summary 

Who is RARC and the OLTS Program?
The Regional Assessment and Resource Centre (RARC) strives to promote equity and access for students with neurodevelopmental disorders by providing evidence-based services and supports, including assessments, training, research, and transition programming. RARC’s On-Line to Success (OLTS) program is designed to support students with disabilities—including learning disabilities, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and mental health disabilities—as they transition from secondary to post-secondary education. Recognizing the need to address the intersectional challenges faced by students with disabilities, RARC has increasingly sought innovative strategies to better serve students whose experiences are shaped by race, ethnicity, culture, gender identity, sexuality, and socioeconomic status. This evaluation builds on that commitment by examining how OLTS is experienced by students with diverse and intersecting identities.

Objectives
This evaluation examined how students with disabilities and intersecting identities experience the transition to post-secondary education and assessed the perceived effectiveness of OLTS. While OLTS has demonstrated value as a disability-focused transition support, less was known about how intersecting identities shape students’ transition experiences and support needs. In collaboration with RARC, this study builds on RARC’s expertise to identify gaps in inclusivity and to develop culturally responsive, anti-oppressive recommendations for program enhancement. Guided by an intersectional framework1, this evaluation examined strengths, gaps, and opportunities for enhancing OLTS through culturally responsive and anti-oppressive approaches that reflect the lived realities of diverse learners.

Evaluation Questions
Following an intersectionality framework, the evaluation addressed the following questions:
1.What barriers do students with disabilities who have diverse and intersecting identities face during their transition to post-secondary education?
2. How effective are existing transition supports, including OLTS, in meeting the needs of these students?
3. What resources and program developments could improve the cultural responsiveness, accessibility, and inclusivity of OLTS for students with intersecting identities?

Methodology
Participants were drawn from former OLTS program cohorts between 2021 and 2024 and were eligible if they were 18 years of age or older, had participated in OLTS, and consented to follow-up research participation. This mixed-methods evaluation combined quantitative survey data (n = 39) and program metrics (2021–2024) with qualitative interviews (n = 9) with former OLTS participants. Integrating descriptive trends with lived experiences allowed the evaluation to identify both what OLTS does well and where students experienced gaps—particularly for those with intersecting marginalized identities.

How Useful is the OLTS Program?
Overall, OLTS was experienced as a meaningful and effective transition support. Participants reported increased confidence navigating post-secondary systems, stronger self-advocacy skills, and improved understanding of disability accommodations. Students described valuing the program’s structure, practical information, and opportunities to learn from facilitators and form connections with peers with lived experience of disability. However, experiences were not uniform: some participants felt that while disability-related supports were strong, other aspects of their identity were less visible within the program.

Satisfaction and Feedback
Participants reported high levels of satisfaction with OLTS, describing the program as accessible, supportive, and practically useful. Students valued the program’s clear structure, organizational learning strategies, neurodiversity-affirming approach, and emphasis on self-advocacy. Satisfaction was often accompanied by constructive feedback. Participants highlighted the need for more explicit attention to intersectional identities, stronger emotional and mental health supports, and continued guidance during the early stages of post-secondary education. These insights point to opportunities for improving OLTS while building on its existing strengths.

Recommendations
Based on the integrated quantitative and qualitative findings, the evaluation identifies opportunities to enhance OLTS through more explicit integration of culturally responsive and intersectional content, strengthened emotional and mental health supports, and extended support beyond program completion. Participants identified structured mentorship and step-by-step guidance for navigating key systems as particularly beneficial additions to the program.

Conclusions
This evaluation demonstrates that RARC’s OLTS program provides a strong foundation for supporting students with disabilities during the transition to post-secondary education. Findings show that OLTS effectively builds confidence, strengthens self-advocacy skills, and improves students’ understanding of disability accommodations. At the same time, the evaluation highlights the importance of attending to intersecting identities and systemic inequities that shape students’ transition experiences. Enhancing OLTS through more explicit intersectional, relational, personalized, and sustained supports would further strengthen its impact and ensure the program continues to empower and meet the diverse needs of the students it serves.