J Dent Educ. 70(5): 475-479 2006
© 2006 American Dental Education Association
From the Students' Corner |
A Review of Exam Accommodations for Dental Students with Disabilities
Aaron D. Johnson, B.S.
Key words: learning disabilities, disabilities accommodation, dental education, licensure exam, standardized testing
Submitted for publication 06/17/05;
accepted 02/22/06
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Abstract
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The purpose of this investigation was to determine the extent to which testing accommodations are granted for students with disabilities in the dental predoctoral and doctoral settings. The investigator aimed to examine both the types of accommodations granted and estimate the number of students seeking accommodations due to a physical or learning disability. To address the research purpose, surveys were sent to the ADA and to each of the ten independent state and four regional dental licensing boards. During the five-year study period (1998–2003), there were 508 requests for accommodations on the Dental Admission Test (DAT) from 49,211 applicants (1.03 percent), 235 accommodation requests for the National Board Dental Examination, Part I from 54,750 applicants (0.43 percent), and 150 accommodation requests for the National Board Dental Examination, Part II from among 40,412 applicants (0.37 percent). Three of the fourteen U.S. licensing agencies (21.4 percent) kept no records, and eleven (78.6 percent) maintained some records. Unfortunately, a rigorous analysis of the impact that the Americans with Disabilities Act has had on standardized testing in dental education cannot be completed because of a lack of data available from the testing agencies.
The Individuals with Disabilities Education Act defines a learning disability as "a disorder in one or more basic psychological processes involved in understanding or using language, spoken or written, that may manifest itself in an imperfect ability to listen, speak, read, write, spell, or to do mathematical calculations." Included in this definition are such conditions as brain injury, perceptual disabilities, dyslexia, minimal brain dysfunction, and developmental aphasia.1 The number of students diagnosed with learning disabilities (LD) is increasing in the United States.2 A set of recent surveys of dental schools found an increasing prevalence of students with learning disabilities. The response rate increased from 57 percent in 1995–96 to 86 percent in 2000–01, while the prevalence increased from 0.2 percent in 1995–96 to 0.9 percent in 2000–01.3 These data indicate that awareness of LD in dental education is increasing. Testing of dental students for LD revealed that approximately 5 percent had a learning disability, 16 percent may have had a learning disability, and 8 percent had some problems but were able to successfully compensate.4
Given these data, it is possible that an under-performing dental student may have an undiagnosed learning disability that requires professional intervention. People differ in their ability to recognize spatial relationships among objects and to perceive small differences in shape, size, position, and texture. For some students, difficulties with spatial-perceptual tasks may be due to the way they process information received from the environment.5 Typically, students with a physical or learning disability receive accommodations appropriate to their disability in order to "level the playing field."6 These accommodations are also granted on admissions and licensure tests such as the Dental Admission Test (DAT), National Board Dental Examination (NBDE), Parts I and II, and the state licensing tests. Previously, no analysis had been conducted of the number of accommodations granted by the testing bodies or the type of accommodations granted.
The purpose of this study was to determine the types of accommodations granted by testing bodies and the number of dental students seeking accommodation for a physical or learning disability on the DAT, the National Boards, Parts I and II, and the regional and state licensing tests during 1998–2003 and also to explore any trends in the number of students seeking accommodations over that time period.
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Methods
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A request for information (Figure 1
) was sent to the supervisor of the Department of Testing Services at the American Dental Association (ADA), which administers the National Boards and the DAT. Data on LD accommodations granted on the DAT and National Boards, Parts I and II were gathered for the previous five years. A similar letter was also sent to each of the ten independent state and four regional dental licensing boards. For the regional licensing boards and independent state licensing boards, surveys were sent to each board’s special accommodations coordinator. The surveys were administered by two means: 1) written and sent via fax or email, 2) telephone. Of the fourteen agencies contacted for the study, four submitted written responses via email, one returned the survey via fax, and eight responded in a phone interview. Responses to the surveys were received during the period of July 2003–April 2005.
The surveys were designed to answer three questions: 1) how many accommodations were granted over a five-year period? 2) what accommodations were normally granted to disabled applicants? and 3) what was the set policy of the testing body in regard to providing accommodations on examinations?
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Results
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Although the initial scope of this survey was to gather data for the years 1998–2003, many state licensure boards had kept data only for the previous year or had combined data for the five-year period.
The records for the accommodations granted for the DAT and National Boards, Parts I and II were not separated by year over the five-year period. During this time period, 508 requests for accommodations were granted for the DAT (out of 49,211 total test takers), 235 requests for accommodations were granted for the NBDE Part I (out of 54,750 test takers), and 150 accommodation requests were granted for the NBDE Part II (out of 40,412 test takers) (Table 1). Students receiving accommodations represented 1.03 percent, 0.43 percent, and 0.37 percent of test takers for the DAT, NBDE I, and NBDE II, respectively (Figure 2a).
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Table 1. Accommodations requested for the Dental Admission Test and National Board Dental Examination (NBDE), Parts I and II, 1998–2003
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There are fourteen licensing agencies in the United States (ten state and four regional). Of these agencies, three kept no records (Hawaii, North Carolina, and WREB), and eleven reported that they had some records (Tables 2a and 2b). Of the agencies that kept records, three kept records for only the previous year, and five kept records for all five previous years. Four agencies reported that they had no requests for accommodations over the five-year period (Indiana, Louisiana, Mississippi, and the Southern Regional Testing Agency, SRTA). As demonstrated in Table 2b, very low rates of testing accommodation requests were recorded by these licensing agencies.
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Discussion
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As a consequence of the implementation of the Americans with Disabilities Act and the increased awareness of learning and physical disabilities throughout society, one might presume that the number of students requesting accommodations on the DAT, National Boards, and licensure tests would be increasing. However, the agencies that administer educational or readiness-to-practice testing in dentistry have not collected or made enough data available to evaluate the significance of any trends in this regard. We found that testing agencies did not keep extensive records of accommodation requests. Most agencies handled each request on a case-by-case basis. The requirements for an accommodation request included documentation of disability and type of accommodations requested.
The accommodation request requirements for the DAT, which are typical, include the following elements:
- Early submission of the request because the special arrangements involved with most accommodations require more processing time than a standard application.
- Documentation of the disability and its effect on the ability of the student to participate in the test. This documentation must include, but is not limited to, a diagnosis of the disability written by a qualified professional, a brief history of the disability including previous accommodations granted, and specific recommended accommodations.7
Testing agencies evaluate the merits of each accommodation request on a case-by-case basis. Physical accommodations reported by respondents included left-handed equipment, wheelchair accommodations, hearing interpreter, and latex free environment. Respondents to this survey reported that the following accommodations were granted to learning disabled students: allowing 50 percent more time to complete the test; spreading testing over two days; providing a separate room for testing away from other students; providing readers, scribes, or interpreters; allowing test takers to use highlighters, colored papers, or ear plugs; allowing subjects to listen to test questions on an audiotape; substituting written tests for computer-based tests; providing frequent rest periods; and allowing students to read questions aloud.
The prevalence of requests for accommodations for each test per year drops from the time the DAT is taken to the time a dental student takes the National Boards, Part II and the licensing examinations (Figure 2a
). This trend could be due to several factors. Students with disabilities might not get accepted to dental schools. Students might adopt new learning styles and not ask for accommodations. Students with disabilities might not need or ask for accommodations for the clinical years since different skills are being used. Upon examining the trends for data from licensing examinations, I found that the number of requests for accommodations appears to be fairly constant across recent testing years (Figure 2b).
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Figure 2b. Percentage of test takers requesting accommodations on state and regional licensure examinations
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The lack of detailed records of testing accommodations kept by the responsible agencies is troubling. It is possible that these agencies have elected not to keep records due to concerns about potential complaints from students who take the test under standard conditions and feel that the accommodations grant an unfair advantage. It is also possible the testing agencies may not keep detailed records to protect the confidentiality of the accommodation seekers. Finally, it is possible that, for legal reasons, the testing agencies did not provide the data though it may exist, even though data obtained by means of this survey could not be linked in any way to specific accommodation seekers.
In the future, more extensive records of accommodation requests should be kept by testing agencies. These data would allow a quantifiable analysis of the trends in the frequency and types of testing accommodations and thus enable evaluation of the impact of the Americans with Disabilities Act on testing in dental education.
Implementation of the Americans with Disabilities Act has increased learning and physical disability awareness throughout professional education including dental school. The percentage of applicants for the DAT, NBDE Part I, NBDE Part II, and regional and state licensure exams who request special testing accommodations appears to be very low, at 1 percent or less for each of these examinations. However, rigorous analysis of the impact that the act has had on standardized testing in dental education cannot be performed because of a lack of data kept by testing agencies. Future efforts should be made to identify programs at dental schools for students with disabilities and to evaluate any trends in national data (NBDE, DAT), for which the ADA and licensure boards keep adequate records.
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Acknowledgments
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The author would like to acknowledge the invaluable assistance of Drs. Nadeem Karimbux and Howard Howell in the preparation of this manuscript.
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Footnotes
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Mr. Johnson is a D.M.D. Candidate at the Harvard School of Dental Medicine. Direct correspondence and requests for reprints to him at Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115;aaron_johnson{at}student.hms.harvard.edu.
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- American Dental Association. At: www.ada.org/prof/ed/testing/dat/special.asp. Accessed: August 12, 2004.
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